Evaluation of Conceptual Framework for Recruitment of African American Patients With Breast Cancer

Abstract

Purpose/Objectives-To describe the Heiney-Adams Recruitment Framework (H-ARF); to delineate a recruitment plan for a randomized, behavioral trial (RBT) based on H-ARF; and to provide evaluation data on its implementation.Data Sources-All data for this investigation originated from a recruitment database created for an RBT designed to test the effectiveness of a therapeutic group convened via teleconference for African American women with breast cancer.Data Synthesis-Major H-ARF concepts include social marketing and relationship building. The majority of social marketing strategies yielded 100% participant recruitment. Greater absolute numbers were recruited via Health Insurance Portability and Accountability Act waivers. Using H-ARF yielded a high recruitment rate (66%).Conclusions-Application of H-ARF led to successful recruitment in an RBT. The findings highlight three areas that researchers should consider when devising recruitment plans: absolute numbers versus recruitment rate, cost, and efficiency with institutional review board-approved access to protected health information.Implications for Nursing-H-ARF may be applied to any clinical or population-based research setting because it provides direction for researchers to develop a recruitment plan based on the target audience and cultural attributes that may hinder or help recruitment.Recruitment, particularly minority accrual, is the Achilles heel of research (Mills et al., 2006; U.S. Department of Health and Human Services, 2000). Accrual to national cooperative clinical trials is 5%-10% (Peppercorn, Weeks, Cook, & Joffe, 2004), and accrual to cancer control and behavior studies ranges from 14%-41% (Carlson, Speca, Patel, & Goodey, 2004;Keyzer et al., 2005;Linden et al., 2007;Margiti et al., 1999;Motzer, Moseley, & Lewis, 1997;Ott, Twiss, Waltman, Gross, & Lindsey, 2006;Richardson, Post-White, Singletary, & Justice, 1998) with few exceptions (Gil et al., 2006). African American participation in studies usually is 5% or less (Bakitas et al., 2009;Blacklock, Rhodes, Blanchard, & Gaul, 2010;Dirksen & Epstein, 2008;Powell et al., 2008). Although multiple and costly efforts have been instituted to increase accrual, researchers still are challenged to meet sample size requirements for their studies. Multiple barriers, such as patient, clinician, system, and trial design, have been cited as contributing to an inability to reach recruitment goals (Advani et al., 2003;BeLue, This material is protected by U.S. copyright law. To purchase quantity reprints, reprints@ons.org. For permission to reproduce multiple copies, pubpermissions@ons.org. Taylor-Richardson, Lin, Rivera, & Grandison, 2006;Cudney, Craig, Nichols, & Weinert, 2004;Dancy, Wilbur, Talashek, Bonner, & Barnes-Boyd, 2004;Heiney et al., 2006;Lichtenberg, Brown, Jackson, & Washington, 2004;Linden et al., 2007;Sears et al., 2003). In addition, knowledge of the unethical research conducted during the U.S. Public Health Service Tuskegee Research Project syphilis study often is cited as a reason for n...

The National Cancer Institute’s Community Networks Program Initiative to Reduce Cancer Health Disparities: Outcomes and Lessons Learned

“…17,18 CNP reports included examples of how community members helped pretest data collection tools, which increased the readability and relevance of these tools. 19,20 Good recruitment and retention rates were attributed to having community members prioritize research needs, help to design recruitment materials, pretest data collection tools, and/or agree to serve as paid or volunteer research staff. 19–24 Community members also provided input on how to disseminate research findings.…”

“…19,20 Good recruitment and retention rates were attributed to having community members prioritize research needs, help to design recruitment materials, pretest data collection tools, and/or agree to serve as paid or volunteer research staff. 19–24 Community members also provided input on how to disseminate research findings. 21,25,26 …”

“…68–71 Participation in CNP activities also increased the number of community members with skills in delivering cancer prevention and control activities, for example, as cancer patient navigators, promotoras , tobacco cessation specialists, and media advocates. 19,47,62,72–75 …”

Antecedents and Mediators of Community Connection in African American Women With Breast Cancer

“…Recruitment has been described elsewhere (Heiney, Adams, Wells, & Johnson, 2010). For the participants in this subsample, recruitment occurred for more than 33 months (between August 2006 and April 2009).…”

Cell therapy and satellite centers: The cardiovascular cell therapy research network experience

“…[4] On some occasions, a multi-center clinical trial will attempt to increase the number of recruiting centers, a maneuver which can spur recruitment and in addition, generate new heterogeneity in the target population. Recruitment strategies to either avoid or respond to lapses in recruitment are a common literature theme [5,6,7]; however, there is little literature on the process by which satellites are accepted and operationalizing into a multicenter study.…”